Basic Information
| Provider Information | |||||||||
| NPI: | 1447241203 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | LENK | ||||||||
| FirstName: | JASON | ||||||||
| MiddleName: | STUART | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | DMD | ||||||||
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| Mailing Information | |||||||||
| Address1: | PSC 41 | ||||||||
| Address2: | BOX 3891 | ||||||||
| City: | APO | ||||||||
| State: | AE | ||||||||
| PostalCode: | 09464 | ||||||||
| CountryCode: | GB | ||||||||
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| Practice Location | |||||||||
| Address1: | UNIT 5210 | ||||||||
| Address2: | BOX 230 | ||||||||
| City: | APO | ||||||||
| State: | AE | ||||||||
| PostalCode: | 09461 | ||||||||
| CountryCode: | GB | ||||||||
| TelephoneNumber: | 1638528124 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 11/02/2005 | ||||||||
| LastUpdateDate: | 07/21/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | X | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1223X0400X | 3061 | NH | Y | Dental Providers | Dentist | Orthodontics and Dentofacial Orthopedics |
No ID Information.